Psy Outpatient

Report on Occupational Therapy Program For Adult Psychiatric Out-Patient (April 2001/March 03)

Prepared by the Working Group on OT Program for Adult Psychiatric Outpatient, OTCOC/HA (December 2003)

Members: Mr. Ip Yee-chiu, DM(OT)/KCH Mr. Frederick Au, DM(OT)/PWH Mr. Leung Kwok-fai, DM(OT)/QEH Mr. Candy Lee, SOT/CPH Ms. Lily Lo, OTI/EKPC Ms. Sharifa Yam, OTI/SKCPC Ms. Daphne Hung, OTI/YMTPC Mr. Raymond Au, OTI/SH Ms. Vicky Chang, OTI/SH Ms. Eyan Tsao, OTI/PWH Mr. Davis Lak, OTI/KH Ms. YoYo Yiu, SOT/KH Mr. Sunny Cheung, OTI/CPH Ms. Codi Wong, RA/QEH

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I.

Background

The aim of psychiatric service is to enable patients to return to the community as soon as possible after treatment and rehabilitation to avoid institutionalization (MSDC –P81, 1999). Therefore, a range of ambulatory and community psychiatric rehabilitation services is essential to reduce prolonged hospitalization or to minimize the need for hospitalization as which could lead to institutionalization and reducing discharge potential. Three and a half OTIIs from the HAHO are allocated to pilot the Out-patient OT Service in Psychiatry (1 OTII each to NTN(CPH /NDH), NTE(PWH/SH), NTS( KCH and cluster clinics) and 0.5 OTII to KH). Hopefully the OT Program for Adult Psychiatric Out-Patient could help the psychiatric out-patients adjust to a structured and purposeful life routine in the community and reduce re-admission. II.

Literature Review

E. Susser et al 1997 concluded that strategies of interventions for individuals with mental illness should be focused on a critical time of transition from shelter institution to the community placement.1 Also, they proposed that the first months of community care living are crucial for adjustment.2 Generally during these first months, relationships are exquisitely fragile and mutual obligations are being negotiated between the de-institutionalized individual and those who may offer formal or informal support in community living. Hence, OT interventions for these out-patients after their discharge from the Hospital will be very crucial. III. Objectives: To enhance psychiatric out-patients’ coping skills such as stress management and problem-solving on the problems they encountered in daily life after discharge, and to promote their work adjustment, retention, and employment opportunity through vocational assessment, counselling and guidance as there is a significant relationship between outpatient defaulters and unemployment ( Pang et al, 1995) The study is to measure the outcomes of the OT program for adult psychiatric patients in the area of occupational & functional performances, work status, living status, health status, happiness and their QOL. IV. Service Mode The OT Program for Adult Psychiatric Out-Patient is a short-term sessional-based ambulatory care service provided by occupational therapist in the Department settings or in the community settings as well as the client’s home environment with definite rehabilitation goals.

V.

Referral Criteria:

Adult psychiatric patients range from 18-60 years of age from psychiatric SOPD. Clients with adjustment problems in work, community living or at home should be referred with the appended Referral Form. (Appendix I)

1

Susser E, et al. Preventing Recurrent Homelessness among Mental Ill Men: A “Critical Time” Intervention after Discharge from a Shelter. American Journal of Public Health. Feb.,1997, Vol.87,No.2:256-262. 2 Valencia E, et al. Critical Time Points in the critical care of homelessness mentally ill individuals. In: Vaccaro JV, Clarke GH Jr, eds. Practicing Psychiatry in the Community: A Manual. Washington, DC: American Psychiatric Press; 1996:259-276.

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VI.

OT Intervention Programs:

VI. 1) Work Adjustment Program for Adult Psychiatric Out-patient (Appendix II) On receiving a referral for work adjustment program, therapist will conduct a screening assessment through interviewing clients and/or their informants, as well as collecting data from case notes. The screening assessment helps to determine if the client can benefit from our service. If an indication for service is rendered, detailed functional assessment will be conducted, which will include work capacity evaluation through standardized assessment tools, work samples or workshop observation. The functional assessment provides therapist and client a complete picture of critical skills required for achieving the treatment goal. A treatment plan will then be formulated together with the client. Necessary services will be provided accordingly, which will mainly include vocational counselling, job planning and preparation, job matching, job hunting, as well as job follow-up. Continuous evaluation of client’s performance will be conducted, through the use of various measurement tools including Work Personality Profile, Workshop Behaviour Checklist, Social & Occupational Functioning Assessment Scale etc. During the treatment implementation period, adjustment of the treatment plan will be made as indicated. On achievement of treatment goal, client will be discharged from the program and secure a job in the community independently.

VI. 2) Home Adjustment Program for Adult Psychiatric Out-patient (Appendix III) When a referral for home adjustment program is received, client will be contacted to attend an initial interview. The interview allows therapist to screen for needs, clarify referral aims, determine suitability of client for O.T. services, make referral to other services, and acquire relevant data from client and/or carer who accompanies client to the interview. Assessment will be conducted to assess client's ability in household management, stress and leisure management, life-style management, relationship building as well as relatives' need of carer support program. Depending on the referred aims and needs of client and their relatives, a variety of assessment tools will be selected for the Home Adjustment program. The St. Louis Inventory Community Living Skills – Chinese version (SLICLS-C) is for household management. The Relative Stress Scale (RSS) is for career support and relationship building. The Social Problem Solving Inventory and other coping style questionnaire are for stress management. The Interest Checklist is for leisure management and the Time Chart for Occupational Life-style Re-design. A treatment plan will be formulated with the client to empower the client to take a more active role in rehabilitation. Treatment programs include training of household management skills, basic relationship building skills, problem solving skills and life-style redesign to achieve a more balanced and healthy living, and to improve their quality of life, as well as making referrals to appropriate services, etc. Treatment will be monitored and modified according to client's progress, and therapist will discuss with client about his or her progress and review their needs. Progress report will be sent to the referred medical officer.

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Client will be discharged from the services when the referred aims are achieved, or a client is found no longer suitable for the OT Program, or self-withdrawal from the Program. The referring medical officer would be contacted, and a case summary would be submitted on completion of the program or termination of services. Therapist will discuss with the client and relevant parties about the need of referrals to other services and further actions on termination of services. VI. 3) Community Adjustment Program for Adult Psychiatric Out-patient (Appendix IV) When a referral for community adjustment program is received, an information collection and screening process will be done for client. An initial interview will be conducted with client and/or their informants. This process helps us to clarify the referral aim and together, to determine whether this client shall benefit from OT Service. A standard assessment on community adjustment skill – “St. Louis Inventory of Community Living Skills” will be conducted as an outcome indicator for this Adult Out-patient project. Whereas detail functional assessment on areas like community living skill, community resources usage and social / coping skill will be conducted subject to the needs of the client. These assessments provide objective measure for therapists and client on treatment program planning. A treatment plan will then be formulated with the client based on his/her needs and problems encountered. Treatment programs will include community living skill teaching and practice, resources orientation, establishment of social support network etc.. Treatment program will be closely monitored and adjusted according to clients’ progress. On-going evaluation report and progress report will be provided. Client will be discharged from the program on achievement of treatment goal. For those clients who show little progress or fail to meet the goal, therapist will review the treatment program and discuss with relevant parties for alternative arrangements VII. Outcome Measurement Tools. The clinical outcome measurements are specified with regard to the protocol of the out-patients services, namely Work Adjustment, Home Adjustment and Community Adjustment. One instrument is chosen for each specific area of treatment.

VII. 1) The Chinese version Work Personality Profile (CWPP) The Chinese version Work Personality Profile (CWPP) is selected as a measure of outcome of the Work Adjustment program. It is an observational work behavioral rating instrument developed by Bolton and Roessler (1986) and was further validated and revised by Mr Chan Siu-ching et al in 2002. It is supposed to measure work attributes essential to maintain employment. It employs a 4-point scale for rating 58 behavioral items subsumed in 11 rational scales. The authors have reported internal consistency of the 11 work performance scales ranging from .71 to .92. Its inter-rater reliability is .80. It is highly correlated (.78) to the General Aptitude Test Battery

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demonstrating good concurrent validity. Its predictive validity is also eminent with p<.05 in predicting vocational competence as well as vocational training program completion. The instrument has also been proved useful for identifying clients’ change in work performance (Lysaker & Bell, 1995). Williams (1997) has further established evidences of its psychometric properties, including content validity, construct validity, concurrent validity and predictive validity.

VII. 2) The Social and Occupational Functioning Assessment Scale (SOFAS) The Social and Occupational Functioning Assessment Scale (SOFAS) will be used to assess outcome of the Home Adjustment program. The SOFAS (Hilsenroth, et al, 2000) is part of the DSM-IV axis V. It is designed to assess a unique domain in the DSM-IV, namely, an individual’s level of social and occupational functioning not directly influenced by the overall severity of psychiatric symptoms. However, it takes into consideration of the effects of the individual’s general medical condition in the evaluation of social and occupational functioning. The inter-rater reliability (ICC) for the scale is found to be .89. Factor analysis of the DSM-IV axis V reveals that the SOFAS measures a specific construct of its own. Furthermore, concurrent validity study shows that the scale has high correlation with the Social Adjustment Scale (SAS) and Inventory of Interpersonal Problems.

VII. 3) The St. Louis Inventory of Community Living Skills (SLICLS) The St. Louis Inventory of Community Living Skills (SLICLS) is chosen for measure of outcome in the Community Adjustment program. It is intended to use for severely ill chronic psychiatric patients (Evenson & Boyd, 1993; Fitz & Evenson, 1995; Fitz, 1999). It measures a single construct – the attainment of community living skills. It is designed to be rated by someone familiar with the client whose current (past week) level of functioning are evaluated using a 7-point scale ranging from few or no skills at one end and self-sufficient, very adequate skills at the other end. It demonstrates high-sounding psychometric properties. Its intraclass correlation coefficient (ICC) is .85 and the Cronbach’s alpha for the mean total score for two raters is .97. The instruments’ construct validity has been demonstrated by its ability to successfully differentiate among clients of different levels of care including private apartment, boarding homes and nursing homes. Concurrent validity has been proved as scores on SLICLS correlated well with the Missouri Level of Care (MLC), as well as clinical staff’s estimates of best placement for clients.

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VII. 4) The Relatives’ Stress Scale (RSS) The Relatives’ Stress Scale (RSS) is selected as a measure of carers’ subjective feelings towards burden in looking after patients3. Items of the scale are selected through literature review and judgment of the authors. Its wordings have been tuned for use with non-professional persons. For each item, a five-point scale (from 0 through 4) is used to indicate either “never, rarely, sometimes, frequently, always” or “not at all, a little, moderately, quite a lot, considerably”.

The instrument has been field-tested on 38 relatives of senile dementia patients who are assessed by research psychologists. Data are then analyzed through factor analysis condensing into 15 items subsumed under three subscales and there is sub-total for each subscale. (i)

personal distress experienced by the relatives in relation to the patient

(ii)

degree of life upset produced by having to care for the patients

(iii)

negative feelings towards patients

Test-retest reliability has been studied with psychologists’ reassessment of the relatives after lapse of three weeks. The reliability coefficients for each subscale were reported ranging from .72 to .88. The authors have also studied the tool’s construct validity. The scale was discriminated with three constructs namely relatives’ perception on patients’ cognitive level, behavioural disturbance and self-care abilities, which were measured by the Clifton Assessment Schedule (CAS), and the physical self maintenance (PSM) and activities of daily living (ADL) scales of Lawton and Brody respectively. The RSS has low correlation with cognition (r=.06), self-care (r=.09) and behavioural disturbance (r=.08).

3

There is currently no specific measure on stress of careers of adult psychiatric patients. The RSS is originally developed for relatives of dementia patients with construct closely related to our interest and is thus adopted for use.

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VIII. Results: VIII. 1) Cases Recruitment: The Out-patients were recruited from the following centers: EKDH, KCH, KH, NDH, PWH, SH, TMMH, YMTPC, SKCPC. Total out-patients treated by the centers from April 01 to March 03 from EIS = 1204 Total cases recruited to the Program = 431 (36% of total out-patients are suitable for the Program, the others may not suitable due to non-compliance to the program, short episodes of care, e.g. vocational counseling service, or vocational assessment or independent living skills assessment, or household assessments) Total cases discharged from the Program as at 31/3/2003 = 164 (38% cases were discharged from the Program in 2 years time and the detail analysis of the outcomes of them are listed below.) Total Number of cases completed Interview at 3 months follow-up = 67 (40.8%) VIII. 2) Drop-outs Cases Loss to follow –up at Discharge =12. (2.8%) Re-admission to Hospital before Discharge= 25 (5.8%) Re-admission to Hospital after Discharge = 2 (1.2%) VIII. 3) Demographic Variables Male –77 Sex: Female – 87 Age:

Mean – 35 (Mini.18 & Maxi. 60)

Education: no formal edu P1-6 F1-5 above F5 Total

Frequency 2 33 100 29 164

Percent 1.2 20.1 61.0 17.7 100.0

Valid Percent 1.2 20.1 61.0 17.7 100.0

Cumulative Percent 1.2 21.3 82.3 100.0

Diagnosis:

schizophrenia schizoaffective disorder bipolar affective disorder depressive episode other anxiety disorder obsessivecompulsive disorder others

Frequency Percent Valid Percent Cumulative Percent 83 50.6 50.6 50.6 3 1.8 1.8 52.4 7

4.3

4.3

56.7

36 9

22.0 5.5

22.0 5.5

78.7 84.1

2

1.2

1.2

85.4

17

10.4

10.4

95.7

7

personality disorder early psychosis Total

1 6 164

Duration of Illness:

.6 3.7 100.0

.6 3.7 100.0

96.3 100.0

Mean 8.3 years (Mini. 0 year & Maxi. 48)

No. of Previous Admissions: Mean 1.77 (Mini. 0 & Maxi. 14) Living Status (Pre & Post Comparison): living status (pre) * living status (dc) Crosstabulation Count living status (dc) 公司宿 中途宿 獨居 舍 舍

與親人同 住 living status (pre)

與親人同 住 獨居 公司宿舍 中途宿舍 其他

Total

1

其他

114

4

6

7 1 5

5

1

1

12

127

10

1

19

Total 1

126

1 2

13 1 18 1 159

The living status of the out-patients remained almost the same after the program. They are well maintained in the living environment 3 months after discharge. VIII. 4) Outcome Assessments: For the Social & Occupational Functioning Assessment Scale (SOFAS), there is significant improvement in discharge. N Minimum Maximum SOFAS_A 148 SOFAS_D 147 Valid N (listwise) 147

35.00 40.00

90.00 95.00

Mean

Std. Deviation 65.9392 9.8404 74.1973 10.3723

Paired Samples Correlations N Pair 1

SOFAS_A & SOFAS_D

Correlation 147

.760

Sig. .000

Paired Samples Test

Mean Pair 1

SOFAS_A SOFAS_D

-8.2177

Paired Differences 95% Confidence Interval of the Difference Std. Std. Error Lower Upper Deviation Mean 7.0327

.5800

8

-9.3641

-7.0713

t -14.167

df 146

Sig. (2-tailed) .000

For the Chinese version Work Personality Profile (CWPP), there are 61 cases (37%) being rated by this scale and also significant improvements in all the 5 domains in discharge. Paired Samples Statistics

Pair 1 Pair 2 Pair 3 Pair 4 Pair 5

cwpp_s1 (adm) cwpp_s1 (dc) cwpp_s2 (adm) cwpp_s2 (dc) cwpp_s3 (adm) cwpp_s3 (dc) cwpp_s4 (adm) cwpp_s4 (dc) cwpp_s5 (adm) cwpp_s5 (dc)

Mean 64.5902 67.8033 63.3333 66.2778 66.4286 71.1310 66.8944 69.9454 72.1311 76.8443

N 61 61 60 60 60 60 61 61 61 61

Std. Deviation 13.2179 14.1124 13.7984 15.1557 12.4797 11.3567 13.1693 13.7260 18.0268 15.9485

Std. Error Mean 1.6924 1.8069 1.7814 1.9566 1.6111 1.4661 1.6862 1.7574 2.3081 2.0420

Paired Samples Correlations N

Correlation

Sig.

Pair 1

cwpp_s1 (adm) & cwpp_s1 (dc)

61

.792

.000

Pair 2

cwpp_s2 (adm) & cwpp_s2 (dc)

60

.728

.000

Pair 3

cwpp_s3 (adm) & cwpp_s3 (dc)

60

.715

.000

Pair 4

cwpp_s4 (adm) & cwpp_s4 (dc)

61

.704

.000

Pair 5

cwpp_s5 (adm) & cwpp_s5 (dc)

61

.644

.000

Paired Samples Test Paired Differences

Std. Deviation

Std. Error Mean

-3.2131

8.8640

1.1349

-5.4833

-.9429

-2.831

60

.006

-2.9444

10.7548

1.3884

-5.7227

-.1662

-2.121

59

.038

-4.7024

9.0516

1.1686

-7.0407

-2.3641

-4.024

59

.000

-3.0510

10.3651

1.3271

-5.7056

-.3964

-2.299

60

.025

-4.7131

14.4633

1.8518

-8.4173

-1.0089

-2.545

60

.014

Mean Pair 1 Pair 2 Pair 3 Pair 4 Pair 5

cwpp_s1 (adm) - cwpp_s1 (dc) cwpp_s2 (adm) - cwpp_s2 (dc) cwpp_s3 (adm) - cwpp_s3 (dc) cwpp_s4 (adm) - cwpp_s4 (dc) cwpp_s5 (adm) - cwpp_s5 (dc)

95% Confidence Interval of the Difference Lower Upper

9

t

Sig. (2-tailed)

df

For the St. Louis Inventory of Community Living Skills (SLICLS), 66 cases (40%) are being rated and there are significant improvements in discharge. Paired Samples Statistics Mean Pair 1

SLICLS-C(adm, 0-100 scale) SLICLS-C(dc, 0-100 scale)

N

Std. Deviation

Std. Error Mean

76.5488

66

14.7857

1.8200

83.6532

66

12.9866

1.5985

Paired Samples Correlations N Pair 1

SLICLS-C(adm, 0-100 scale) & SLICLS-C(dc, 0-100 scale)

Correlation 66

Sig.

.800

.000

Paired Samples Test Paired Differences 95% Confidence Interval of the Difference Std. Std. Error Deviation Mean Lower Upper

Mean Pair 1

SLICLS-C(adm, 0-100 scale) SLICLS-C(dc, 0-100 scale)

-7.1044

8.9525

1.1020

-9.3052

-4.9036

t -6.447

Sig. (2-tailed)

df 65

.000

For the Relatives’ Stress Scale (RSS), only 17 cases (10%) are being rated though the changes in the 4 sub-scales are significant. Paired Samples Statistics Mean Pair 1

Pair 2

Pair 3

Pair 4

RSS-personal distress (adm, 0-100 scale) RSS-personal distress (dc, 0-100 scale) RSS-life upset (adm, 0-100 scale) RSS-life upset (dc, 0-100 scale) RSS-negative feelings (adm, 0-100 scale) RSS-negative feelings (dc, 0-100 scale) RSS-total score (adm, 0-100 scale) RSS-total score (dc, 0-100 scale)

N

Std. Deviation

Std. Error Mean

22.3039

17

21.9958

5.3348

18.3824

17

22.6815

5.5011

23.8235

17

22.0461

5.3470

21.4706

17

22.8968

5.5533

25.0000

17

20.4920

4.9700

18.7500

17

20.1314

4.8826

20.5882

17

22.7756

5.5239

17.4510

17

22.6853

5.5020

10

Paired Samples Correlations N Pair 1

Pair 2 Pair 3

Pair 4

RSS-personal distress (adm, 0-100 scale) & RSS-personal distress (dc, 0-100 scale) RSS-life upset (adm, 0-100 scale) & RSS-life upset (dc, 0-100 scale) RSS-negative feelings (adm, 0-100 scale) & RSS-negative feelings (dc, 0-100 scale) RSS-total score (adm, 0-100 scale) & RSS-total score (dc, 0-100 scale)

Correlation

Sig.

17

.982

.000

17

.991

.000

17

.905

.000

17

.980

.000

Paired Samples Test Paired Differences

Mean Pair 1

Pair 2 Pair 3

Pair 4

RSS-personal distress (adm, 0-100 scale) RSS-personal distress (dc, 0-100 scale) RSS-life upset (adm, 0-100 scale) - RSS-life upset (dc, 0-100 scale) RSS-negative feelings (adm, 0-100 scale) RSS-negative feelings (dc, 0-100 scale) RSS-total score (adm, 0-100 scale) RSS-total score (dc, 0-100 scale)

Std. Std. Error Deviation Mean

95% Confidence Interval of the Difference Lower Upper

t

Sig. (2-tailed)

df

3.9216

4.2875

1.0399

1.7172

6.1260

3.771

16

.002

2.3529

3.1213

.7570

.7481

3.9578

3.108

16

.007

6.2500

8.8388

2.1437

1.7055

10.7945

2.915

16

.010

3.1373

4.5599

1.1059

.7928

5.4817

2.837

16

.012

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For the working status of the cases pre- & post-discharge, the number of cases being employed increased from 22 to 47 at discharge, the number of cases unemployed from 89 drops to 45. working status (pre) * working status (dc) Crosstabulation Count working status (dc) 全職受 固定兼 兼職自 薪 職 僱 4 1 1 1 1

working全職受薪 status 固定兼職 (pre) 全職自僱 兼職自僱 散工 學生 3 照顧家庭 1 協助照顧家庭 因殘疾退休 因年老退休 放病假 1 失業-正找尋工作 6 失業-沒有找尋工 3 作 其他 庇護工場 日間醫院 2 訓練及活動中心 學員 訓練及活動中心 會員 Total 20

散工 1

就讀職 失業-正 失業-沒 照顧家 協助照 因殘疾退因年老退 業培訓 找尋工 有找尋 學生 庭 顧家庭 休 休 放病假 課程 作 工作 其他 2 3 1 1 1 1

1

1

1

10

5

訓練及活 庇護工 日間醫 動中心學 場 院 員 Total 1 15 2 1 2 2 1 1 7 1 1 18 2 1 2 1 3 1 1 39

2

15

8

1

1 1

1 2 2

11 1

1 1 2 1

8

1

3

6

1

1

1

1 4

1

1

1

1

2

51

1

2 4 6

1

1 1

6 2 2

1 1

18

3

6

8

20

3

1

12

3

3

4

31

1

15

5

13

4

1

1

2

159

Number of unemployment months before joining the Program: Mean 14 (Mini.1 & Maxi. 48) Their main financial source before the program comparing to discharge is quite the same, the number of self earning increases from 35 to 42. main financial source(pre) * main financial source(dc) Crosstabulation Count main financial source(dc) 由家人/ 綜緩/傷 朋友支 自己賺 殘津貼 持 錢 main financial source(pre)

綜緩/傷殘津 貼 由家人/朋友 支持 自己賺錢

Total

Total

43

8

20

71

15

28

7

50

12 70

8 44

15 42

35 156

For the Occupational Performance Assessment Questionnaire, the mean rating score is 3.2 during admission & 3.6 during discharge showing significant improvement subjectively. Occupational Performance Assessment Questionnaire Rating N opaq (adm) opaq (d/c) Valid N (listwise)

163 162

Minimum 1.00 2.00

Maximum 4.43 4.57

Std. Deviation .5994 .4958

Mean 3.2051 3.6085

161

Paired Samples Correlations N Pair 1

opaq (adm) & opaq (d/c)

Correlation 161

.392

Sig. .000

Paired Samples Test

Mean Pair 1

opaq (adm) - opaq (d/c)

-.4082

Paired Differences 95% Confidence Interval of the Difference Std. Std. Error Deviation Mean Lower Upper .6113

4.82E-02

-.5033

-.3130

t -8.472

df 160

For the Subjective rating on their Life satisfaction, the mean score is 3 during admission & 3.45 during discharge showing significant improvement.

13

Sig. (2-tailed) .000

Life Satisfaction Questionnaire N life satisfaction (adm) life satisfaction (d/c) Valid N (listwise)

163 162 161

Minimum 1.25 1.00

Maximum 4.75 4.50

Mean 3.0153 3.4537

Std. Deviation .6308 .6125

Paired Samples Correlations N Pair 1

life satisfaction (adm) & life satisfaction (d/c)

Correlation 161

Sig.

.238

.002

Paired Samples Test Paired Differences

Mean Pair 1

life satisfaction (adm) - life satisfaction (d/c)

-.4363

95% Confidence Interval of the Difference Lower Upper

Std. Std. Error Deviation Mean .7697

6.07E-02

-.5561

t

-.3165

df

-7.193

Sig. (2-tailed)

160

.000

For the perceived Health status & QOL, there are more satisfied on discharge. health status(pre) * health status(dc) Crosstabulation Count

extremely dissatisfied health status(pre)

extremely dissatisfied dissatisfied neither satisfied nor dissatisfied satisfied extremely satisfied

Total

health status(dc) neither satisfied nor dissatisfi dissatisfi ed ed satisfied

2

1

2

5

2

22

15

28

1

2

8

11

1

8 1 34

4

42 2 88

6

14

29

extremely satisfied

Total 10

1

68 22

1 2 4

56 5 161

QOL(pre) * QOL(dc) Crosstabulation Count

QOL(pre)

extremely dissatisfied dissatisfied neither satisfied nor dissatisfied satisfied extremely satisfied

Total

extremely dissatisfie d

dissatisfi ed

QOL(dc) neither satisfied nor dissatisfi ed

2

1

1

4

1

9

19

23

1

53

3

23

19

1

46

1

2

5

1

4

15

48

42 3 91

51 3 161

extremely satisfied

satisfied

Total 8

3

For the overall happiness of the discharged cases, there is a significant shift to the happy side. happiness(pre) * happiness(dc) Crosstabulation Count

unhappy happiness(pre)

unhappy slightly happy happy to a certain extent very happy extremely happy

Total

3 1

happiness(dc) happy to Slightly a certain happy extent 11 12 15 29 4

4

30

very happy

extremely happy 9 4

Total 35 49

48

12

1

65

2

7

91

32

1 2 4

10 2 161

For the satisfaction towards OT service at discharge, the mean rating is 3.9 which is satisfactory. Satisfaction towards OT Service at Discharge N OT serv satisfaction (d/c) Valid N (listwise)

161

Minimum

Maximum

2.00

5.00

Mean 3.9074

Std. Deviation .4448

161

At 3 months Follow-up, there is no change for their perceived health status, QOL score & perceived happiness which means that they are well maintained with no deterioration.

15

health status(dc) * health status(3m) Crosstabulation Count health status(3m) neither satisfied nor dissatisfi satisfied ed

dissatisfi ed health status(dc)

extremely dissatisfied

Total

2

dissatisfied neither satisfied nor dissatisfied satisfied extremely satisfied Total

extremely satisfied

2

6

5

2

13

3

9

2

14

2

2

33

13

16

37

2 1 3

39 1 69

QOL(dc) * QOL(3m) Crosstabulation Count

dissatisfi ed QOL(dc)

extremely dissatisfied dissatisfied neither satisfied nor dissatisfied satisfied extremely satisfied

QOL(3m) neither satisfied nor dissatisfi ed satisfied

Total

2

2

4

Total

extremely satisfied

2

6 19

4

10

5

2

3

35 1 43

12

13

40 2 69

1 1

happiness(dc) * happiness(3m) Crosstabulation Count

unhappy happiness(dc)

Total

unhappy slightly happy happy to a certain extent very happy extremely happy

1 1

happiness(3m) happy to slightly a certain happy extent 1 1 7 3

2

4

very happy

extremely happy

3 11

3

27

6

1

1

13 1 20

12

32

For the perceived change of QOL at discharge. 86% of cases expressed improvement.

16

Total

38 1 1

15 2 69

Change of QOL at Discharge Frequency Valid

Missing Total

extremely improved much improved a little bit improved unchanged extremely worse Total System

Valid Percent

Percent

Cumulative Percent

7

4.3

4.4

4.4

49 82 21 1 160 4 164

29.9 50.0 12.8 .6 97.6 2.4 100.0

30.6 51.3 13.1 .6 100.0

35.0 86.3 99.4 100.0

For the perceived change of QOL at 3-months Follow-up, 65% cases showed improvement & 32% cases expressed no change which means that they are well maintained again. Change of QOL at 3-months Follow-up Frequency Valid

Missing Total

extremely improved much improved a little bit improved unchanged a little bit worse much worse Total System

Valid Percent

Percent

Cumulative Percent

2

1.2

2.9

2.9

12 31 22 1 1 69 95 164

7.3 18.9 13.4 .6 .6 42.1 57.9 100.0

17.4 44.9 31.9 1.4 1.4 100.0

20.3 65.2 97.1 98.6 100.0

When comparing their satisfaction towards their living status & working status before admission to discharge, it shows significant changes in their satisfaction. Comparision of Satisfaction to Living Status & Working Status before Admission & at Discharge Mean Pair 1

Pair 2

satisfy with living status (pre) satisfy with living status (dc) satisfy with working status (pre) satisfy with working status (dc)

N

Std. Deviation

Std. Error Mean

3.4088

159

.9086

7.21E-02

3.6604

159

.8331

6.61E-02

2.6899

158

.9300

7.40E-02

3.1709

158

.8309

6.61E-02

Also, when comparing between discharge & 3-months follow-up, it shows significant changes in their satisfaction.

17

Comparision of Satisfaction to Living Status & Working Status at Discharge & 3-months Follow-up Mean Pair 1

Pair 2

satisfy with living status (dc) satisfy with living status (3m) satisfy with working status (dc) satisfy with working status (3m)

N

Std. Deviation

Std. Error Mean

3.7101

69

.8243

9.92E-02

3.83

69

.73

8.75E-02

3.2319

69

.7886

9.49E-02

3.45

69

.80

9.58E-02

The Service Statistics: Length of Stay in Psy. Out-patient OT Service N date of complete OT - date of commence OT(x21-x05), days Valid N (listwise)

Minimum

Maximum

3.00

514.00

160

Mean

Std. Deviation

145.5938

108.3635

160

Psy. Out-patient OT Attendances N No. of out-pt attn Valid N (listwise)

155

Minimum 1.00

Maximum 202.00

Mean 20.8774

Std. Deviation 27.4818

155

Number of COT Visits & Telephone Contacts N no. of COT visit no. of tel consultation Valid N (listwise)

132 135 131

Minimum 0 0

Maximum 10 30

Mean .47 2.24

Std. Deviation 1.41 4.02

IX. Conclusions: With the existing service delivery mode in HA Psychiatric OT Departments, about 36% (431) of the total psychiatric Out-patient referrals (1204) will receive intensive OT rehabilitation services. Among them, 164 are discharged within 2 years. Their mean length of stay in Psy out-patient OT program is about 5 months. Their mean age is 35 years old with the average duration of illness is 8.3 years. Half of them are suffering from Schizophrenia, 22% are suffering from Depressive Episodes. 25 cases were re-admitted to the Hospital during this 2 years period (5.8%). Their mean period in receiving the OT services is 85.5 days (min 9 days, max 214days, 16 cases with unknown length of period). Comparing to KCH statistics, the total re-admissions in 2003 was 2444 , with 26000 active cases followed-up under the KCH cluster Psy Out-patient Units, the re-admission rate is about 9.4%.

18

This can be the baseline for our future benchmarking purpose. Functionally, they all showed significant improvements. For work aspect, in the domains of Social, adaptability, Self control, personal presentation, attitudes under supervision, the improvement is significant. (N=60, p<0.001)For the community living skills, N=66, p<0.001. For the Relative Stress Scale, improvement is significant in the scales of Personal Distress, Life Upset, Negative Feelings and Total scores, N=17, p<0.001. The involvement of the carers in this group of outpatients was relatively low, only 10% of cases were rated by the RSS. Their main financial sources on self earnings increased from 35 to 42 at discharge, i.e. more patients became self sufficient after the program. For the unemployment status, the number of unemployed cases at discharge dropped from 90 to 46 showing that 27% decrease in the unemployment rate among this group of cases. Among them, their average number of unemployment months is 14 ranging from 1 month to 48 months. This shows that the active vocational rehabilitation service is beneficial for them. For the overall Occupational Performance & Life Satisfaction, the mean rating score increased from 3.2 to 3.6 showing significant improvement in self-perceived performance. (N=161, p<0.001) For the overall perceived Health status, QOL score & perceived happiness, there is a shift to positive improvement at discharge while at 3 months follow-up, there is no change indicating a good maintenance. For the perceived change of QOL at discharge, 86% showed improvement while at 3 months follow-up, 65% expressed improvement & 32% expressed no change indicating a good maintenance. They are also satisfied with both their living & working status at discharge & 3 months follow-up. (N=158, p<0.001) At discharge, their satisfaction towards the OT service given to them is Satisfactory with the mean score 3.9 (N=161). Psychiatric Out-patients under the Psychiatric Out-patient OT program are well maintained in the aspects of occupational performance, life satisfaction, employment status, living status, health status & QOL. X. Recommendations The Program was very helpful to the Psychiatric Out-patients. It can be implemented in all the psychiatric OT Department with out-patient services. Regular data collection cab be continued and reinforced so that further analysis can be done later. The RSS can be deleted as the involvement of the carers is still limited, the focus for outcome measurement will still be put on the psychiatric out-patients themselves. XI.

References

Bolton, B., and Roessler, R. (1986). Manual for the work personality profile. Fayetteville, AR: University of Arkansas Research & Training Center in Vocational Rehabilitation.

19

Everson, R.C., & Boyd, M.A. (1993). The St. Louis inventory of community living skills. Psychosocial Rehabilitation Journal, 17(2): 93-99. Fitz, D., & Evenson, R.C. (1995). A validity study of the St. Louis inventory of community living skills. Community Mental Health Journal, 31(4): 369-377. Fitz, D. (1999). Recommending client residence: a comparison of the St. Louis inventory of community living skills and global assessment. Psychiatric Rehabilitation Journal, 23(2): 107-113. Hilsenroth, M.J., et al. (2000). Reliability and validity of DSM-IV axis V. American Journal of Psychiatry. 157(11): 1858-1863. Lysaker, P., & Bell, M., (1995). Work performance over time for people with Schizophrenia. Psychosocial Rehabilitation Journal, 18(3): 141-146. Williams,R. (1997). Work personality profile: validation within the supported employment environment. Journal of Rehabilitation, 63(2): 26-31. Greene J.G., et al (1982). Measuring behavioral disturbance of elderly demented patients in the community and its effects on relatives: a factor analytic study. Age and Ageing. 11: 121-126. XII.

Appendices:

Appendix I : Psychiatric Out-patient Referral Form Appendix II : Work Adjustment Program Appendix III : Home Adjustment Program Appendix IV : Community Adjustment Program Appendix V : Relative Stress Scale Appendix VI : St. Louis Inventory of Community Living Skills – Chinese Version Appendix VII : Social and Occupational Functioning Assessment Scale Appendix VIII : Chinese Work Personality Profile Appendix IX : Occupational Therapy Generic Outcome Questionnaire, Hospital Authority

20

Appendix I: Referral Form on OT Program for Psychiatric Out-patient KWAI CHUNG HOSPITAL

(Please affix label)

OCCUPATIONAL THERAPY PSYCHIATRIC OUT-PATIENT SERVICES

Hospital / OPD No: Name: ID No:

REFERRAL FORM

Sex:

Age:

Team:

Diagnosis: Presenting Problem:

? Ordinary

Status:

Precautions (Psychiatric):

? PFU Target ? Suicidal

Precautions (Medical): ? Epilepsy

? PFU Subtarget

? Aggressive

? Others:

? Diabetes Mellitus

? Chronic Obstructive Pulmonary Disease

? Hypertension ? Others:

Referral Aims:

? Work Adjustment Program e.g. work capacity evaluation; work related social skills training; job planning & preparation; job placement; supported employment; vocational counseling; on site job visit, etc. (please specify, if necessary)

? Home Adjustment Program e.g. household management; career support & relationship building; stress & leisure management; etc. (please specify, if necessary)

? Community Adjustment Program e.g. community living skills; use of community resources; social & coping skills enhancement, etc. (please specify, if necessary)

? Occupational Life-Style Re-design e.g. structured use of daily routines, etc. (please specify, if necessary)

? Others (please specify, if necessary)

Date of Referral:

Referring Medical Officer (Signature) (Name in block letter) (Tel. No)

Appendix II: “Work Adjustment Program for Adult Psychiatric Out-patients”

Occupational Therapy referral for WORK ADJUSTMENT PROGRAM

Data base collection

Screening Assessment

Problem Identification

Continue Occupational

No Recommend or Refer to other services

Therapy service? Yes

Termination of Occupational Therapy service

Outcome Measurement: “Admission”

Functional assessment

Work Capacity Evaluation, WPP, WBC, Relative Stress Scale, Social & Occupational Functioning Assessment Scale

Treatment Plan formulation

Treatment Implementation

Vocational

Counselling,

Job

Planning

&

Preparation,

Work-related Social Skill, Job Placement, Job Follow-up No Treatment Goal meet? Yes Outcome Measurement: “Discharge”

Termination of Occupational Therapy service

Outcome Measurement: “Follow Up”

“Work Adjustment Program for Adult Psychiatric Out-patients”

Appendix III: Home Adjustment Program for Adult Psychiatric Out-patient

Referrals from Case Medical Officer (C.M.O.) (case summary attached) ⇓ OPD Occupational Therapist to contact client to clarify referred aims and O.T. services ⇓

÷

ø

Initial Interview (with client and /or carer)

If not suitable for O.T. services ⇓ Inform C.M.O.

⇓

O.T. services ⇓

Assessment

Inform C.M.O.

⇓

and /or recommend

and /or recommend

Formulate Treatment Plan with client

other services

⇓

⇓

Client is discharged

other services

⇓ Client is discharged

OT intervention

from O.T.services

If refusal of

from O.T. services

⇓

Review of Progress and Treatment Plan with Client Document Progress Report and further treatment if required ÷ ø

Little Progress or refusal of treatment ⇓

Terminate O.T. services, and send Discharge summary

Achieve Treatment Goal ⇓

Terminate O.T. services, ⇓

inform CMO and send Discharge Summary

1

Appendix IV: Community Adjustment Program for Adult Psychiatric Out-patient

Appendix V

RELATIVES’STRESS SCALE (RSS)

Score 2 3

1.

Do you ever feel you can no longer cope with the situation? 你曾否覺得你不能再面對這情況？

0

1

2.

D you ever feel that you need a break? 你曾否覺得你需要一點休息？

0

1

2

3

4

3.

Do you ever get depressed by the situation? 你曾否因這情況而情緒低落？

0

1

2

3

4

4.

Has your own health suffered at all? 你自己的健康有否轉差？

0

1

2

3

4

5.

Do you worry about accidents happening to … … ? 你會否憂心… … 發生意外？

0

1

2

3

4

6.

Do you ever feel that there will be no end to this problem? 你曾否覺得此問題永沒了結？

0

1

2

3

4

7.

Do you find it difficult to get away on holiday? 你有否覺得在假期不能分身？

0

1

2

3

4

8.

How much has your social life been affected? 你的社交生活受影響有多少？

0

1

2

3

4

9.

How much has the household routine been upset? 你的日常家務受打擾有多少？

0

1

2

3

4

10.

Is your sleep interrupted by … … ? 你的睡眠有否受… … 打擾？

0

1

2

3

4

11.

Has your standard of living been reduced? 你的生活質素有否因而下降？

0

1

2

3

4

12.

Do you ever feel embarrassed by … … ? 你曾否因… … 而感到尷尬？

0

1

2

3

4

13.

Are you at all prevented from having visitors? 你有否因此而避免有訪客？

0

1

2

3

4

14.

Do you ever get cross and angry with … … ? 你曾否對… … 感到憤怒？

0

1

2

3

4

15.

Do you ever feel frustrated at times with … … ? 你曾否有時對… … 感到氣餒？

0

1

2

3

4

Subscales: Q. 1-6 □ (Personal distress) Q. 7-11 □ (Life upset) Q. 12-15 □ (Negative feelings)

□ / 20

□

□ / 60

Total score:

□ / 24

□ / 16

Code: never / not at all rarely / a little sometimes / moderately frequently / quite a lot always / considerable 01/2/RSS

從不 / 一點沒有 很少時候 / 少許 有些時候 / 中等 經常 / 頗多 所有時候 / 很多

Score 0 1 2 3 4

4

Appendix VI

St. Louis Inventory of Community Living Skills – Chinese Version 聖路易社區生活技巧評估 – 中文版 (SLICLS-C) 機構 __________________ 姓名 __________________ 評估者 _________________

日期 _____________________ 編號 _____________________

運用以下的評分方法去評核當事人最近(過往一週)的能力程度: 1. 2. 3. 4. 5. 6. 7.

很少或是缺乏技巧 需要大量的幫助或是改進 需要中度的幫助或是改進 能力程度不清楚或未能觀察 有中度的技巧 有大量的技巧 有足夠的能力﹐無需他人幫助

圈出你認為最能代表當事人在各方面的能力的數字。 請根據實際可觀察的表現去評分﹐不要假設當事人的能力。 請謹記你是需要評核當事人的正面行為及技能。 如當事人未有機會表現其能力﹐請圈出"4"﹐例如未能在當事人住院期間觀察到預備飲食的能力。 1.

個人衛生, 例如﹕淋浴或洗澡﹐牙齒的護理﹐ 1 日常一般的清潔等。

2

3

4

5

6

7

2.

儀容護理, 例如﹕頭髮和手部的護理, 剃鬍 或化妝和個人的外觀等。

1

2

3

4

5

6

7

3.

處理衣著﹐例如﹕自己穿著衣服﹐選擇適當 的衣服﹐在一日中經常保持衣著服整潔等。

1

2

3

4

5

6

7

4.

個人自理﹐例如﹕執床、清潔地方、擺放物 件等。

1

2

3

4

5

6

7

5.

溝通﹐例如﹕當有需要時要求別人幫忙﹐表 達自己的渴望﹐適當地表達自己的感受﹐及 與別人作有意義的對話等。

1

2

3

4

5

6

7

6.

安全﹐例如﹕正確處理香煙､火柴､工具､ 書寫工具及玻璃等。

1

2

3

4

5

6

7

7.

處理時間﹐例如﹕安排出席約定的聚會﹐準 時回返﹐參與約定的活動及準時上班等。

1

2

3

4

5

6

7

8.

處理金錢﹐例如﹕有合理的使用金錢習慣﹐ 有預算理財能力, 能保管金錢等。

1

2

3

4

5

6

7

9.

閒暇活動﹐例如﹕參與多元化的活動﹐如閱 報､閱讀書藉､觀賞電視､參與預先組織好 的活動﹐嗜好活動､縫紉﹐啤牌遊戲等。

1

2

3

4

5

6

7

10. 衣服保養﹐例如﹕洗衫,熨衫﹐縫鈕、修補衣 服等。

1

2

3

4

5

6

7

11. 預備膳食﹐例如﹕烹調, 購買材料､上菜､使 用微波爐及洗碗碟等。

1

2

3

4

5

6

7

12. 性徵﹐例如﹕負責任和檢點的行為､專重別 人的私人權利､及安全性行為的知識等。

1

2

3

4

5

6

7

13. 資源運用﹐例如﹕電話､交通､餐廳/酒樓､ 行街購物和其他社區服務等。

1

2

3

4

5

6

7

14. 解決問題﹐例如﹕某程度的獨立､在有需要 時懂得尋求幫助､作決定的基本能力､懂得 向人發問。

1

2

3

4

5

6

7

15. 保健事宜﹐例如﹕保持均衡營養、控制體重、 保持適量運動、處理藥物等。

1

2

3

4

5

6

7

16. 身體的損傷: ¨ 需要輪椅 ¨ 用拐杖､手杖或助行架。 ¨ 用義肢 ¨ 失聰或部份失聰 ¨ 失明或部份失明 ¨ 其他__________ 1 – 15 項的總分:

評語:

Appendix VII

Occupational Therapy Department – KCH Social and Occupational Functioning Assessment Scale (SOFAS) Hospital ___________________ Patient Name _______________ DOA ______ Age ___ Sex ___ SOFAS Score _______________

ID No: ____________________ Date of Assessment __________ Diagnosis: _________________ Rater __________________

Consider social and occupational functioning on a continuum from excellent functioning to grossly impaired functioning. Include impairments in functioning due to physical limitations, as well as those due to mental impairments. To be counted, impairment must be a direct consequence of mental and physical health problems; the effects of lack of opportunity and other environmental limitations are not to be considered. Code

(Note: Use intermediate codes when appropriate, e.g. 45, 68, 72)

100 | 91

Superior functioning in a wide range of activities.

90 | 81 80 | 71

Good Functioning in all areas, occupationally and socially effective.

70 | 61

Some difficulty in social, occupational (e.g., frequent work absences, work occasionally incomplete or judged “not up to standards”) or school functioning (e.g., occasional truancy, or theft within the household), but generally functioning pretty well, has some meaningful interpersonal relationships.

60 | 51

Moderate difficulty in social (e.g., few friends, conflicts with peers or co-workers), occupational, or school functioning, (e.g., unable to complete work assignments, unsatisfactory work performance).

50 | 41

Serious impairment in social, occupational, or school functioning (e.g., no friends, unable to keep a job at expected or prior level of performance).

40 | 31

Major impairment in several areas, such as work or school, family relations (e.g., depressed person avoids friends, neglects family, and is unable to work; child frequently beats up younger children, is defiant at home, and is failing at school).

30 | 21

Inability to function in almost all areas (e.g., stays in bed all day; no job, home, or friends).

20 | 11

Occasionally fails to maintain minimal personal hygiene (e.g., smear feces), unable to function independently.

10 | 1

Persistent inability to maintain minimal personal hygiene. Unable to function without harming self or others or without considerable external support (e.g. nursing care and supervision).

0

Inadequate information

No more than a slight impairment in social (e.g., infrequent interpersonal conflict), occupational (e.g., missing a few deadlines or appointment), or school functioning (e.g., temporarily falling behind in schoolwork).

Psy/Out/1/12/2001

Appendix VIII Please Use Block Letter or Affix Label KWAI CHUNG HOSPITAL Medical Record No.: OCCUPATIONAL THERAPY DEPARTMENT Name :

The Chinese Work Personality Profile

I.D. No.:

Sex :

Dept. :

Age :

Ward / Bed No.:

Case OT :

Date :

工作性格評估表 請將你對該學員所觀察到表現? 用下列五個選擇? 完成後面五十八個行為項目?

(4)

肯定具有能力? 是一個受僱的長處

(3)

表現恰當? 但並非特別的優點

(2)

表現反復不定? 可能是受僱條件上的一個問題

(1)

在這方面有問題? 肯定會限制了該學員受僱的機會

(X)

無機會觀察到這種表現

工作適應力 社交技巧 1) 有充份的警覺性 2) 迅速地學會所分派得的新工作 3) 在整段工作期內能穩定地工作 4) 接受工作中的任何改動 5) 實質上不需要直接的指導 6) 以恰當的方式要求幫助 7) 有信心地接觸導師 8) 能跟導師友善相處 9) 在群策群力的事上感到自豪 10) 對別人正在做的事情感到興趣 11) 能適當地表達喜愛或厭惡的感受 12) 會按時主動做一些與工作有關的活動 13) 接受導師分派的工作及指示而不作爭議 14) 經過指示之後便會改善表現 15) 不抗拒做刻板的工作

自我控制

受督導的 看法

個人儀容

工作適應力 社交技巧 16) 願意嘗試新的工作 17) 不必敦促也會去做分派到的工作 18) 如果對工作有不清楚時會要求進一步的指導 19) 接受更正而不會不開心 20) 只與導師討論跟工作有關的個人問題 21) 接受分派去做集體工作 22) 選擇工作伙伴作為朋友 23) 當別人引起對話時會有回應 24) 遵守規則 25) 保持令人滿意的個人衛生習慣 26) 經過指示後便會改變工作方法 27) 在工作時會注意到細節部份 28) 就算工作程序有所改變伋能維持生產能力 29) 能發現自己的錯處 30) 在工作上遇到困難時會要求協助 31) 能輕鬆自若地與導師相處 32) 懂得跟職員相處 33) 在做集體工作時能做得輕鬆自然 34) 在與人交往時表現得自然從容 35) 會主動跟別人談話 36) 對不雅及粗俗語言的使用能作出恰當的判斷 37) 會穿合適的衣著往工作 38) 經過更正後會保持用改善了的工序工作 39) 就算受外界干擾而出現分心的情況仍能維持工作速率 40) 在一些富變化及多樣化的工作上能有滿意的表現 41) 能匕動改正錯誤 42) 有導師在場時仍能有穩定的表現 43) 在集體工作中會對其他人表示支持 44) 如果有社交小組的話? 他會參與 45) 當別人說話時會聆聽而不會插咀 46) 做出成績後會表示欣喜 47) 能留心地聆聽教導或指正 48) 能夠輕易地從一件工作轉到另一件工作去 49) 需要的監督較正常為少 50) 在有須要時會給工作伙伴提供協助 51) 經常被伙伴們推舉出來 52) 能表達正面的感受? 例如? 讚賞別人? 喜歡別 人等 53) 在開玩笑頑皮搗蛋時懂得節制 54) 能將以前所學過的技能運用到新工作上 55) 在處理問題時只間中需要協助

自我控制

受督導的 看法

個人儀容

工作適應力 社交技巧

自我控制

受督導的 看法

個人儀容

56) 承擔集體工作中所分派得的任務 57) 能適當地表達一些負面的感受? 如? 憤怒? 恐懼? 憂愁等 58) 能控制脾氣 總分?

/100

/60

請將你對該學員所觀察到表現? 用下列五個選擇? 完成後面五十八個行為項目?

(4)

肯定具有能力? 是一個受僱的長處

(3)

表現恰當? 但並非特別的優點

(2)

表現反復不定? 可能是受僱條件上的一個問題

(1)

在這方面有問題? 肯定會限制了該學員受僱的機會

(X)

無機會觀察到這種表現

/28

/36

/8

PSY-D/O-AD 醫院管理局

Appendix IX

職業治療服務問卷 (訪問版) To be administered by case therapist or interviewer around the time of starting of the Day- / Out-patient OT service. (All scores should be entered into the subject corresponding answer book.) [Interviewer should read the followings to the subject]

在為你提供治療、訓練及服務之前, 我們希望透過這份問卷，了解一下你對現在 生活的滿意程度。你的意見能幫助我們為你計劃更合適及完善的服務。 呢份問卷以訪問形式進行, 我會將問題讀出，你如果唔明白條問題可以問我，跟 著我會讀五個形容詞比你聽，呢五個形容詞係由「最唔滿意」到「最滿意」排 列出來，你只要在五個形容詞當中揀出一個最可以反映你感受的形容詞話比我 知就得。

[Read the followings to the subject for practice.]

例題 我地先試下一些例題 你滿唔滿意現在的生活？ 我先解釋一下。「滿唔滿意」係屬於個人的感受，唔同人對「滿意」的定義 可能唔同， 你只需要就你對「滿意」的理解講出自己的感受。 唔同人評定 「滿意」的標準都可能唔一樣，請你根據你個人的標準同期望來評定你的滿 意程度。 我再讀一次條問題。 你滿唔滿意現在的生活？(停頓兩秒) 我而家讀五個形容詞比你聽。 o1 極唔滿意 o2 唔滿意 o3 無話滿唔滿意 o4 滿意 o5 極滿意 你覺得邊個形容詞最適合形容你的感受？ 我地再試一題 你滿唔滿意有關治療你疾病的設備？(停頓兩秒) o1 極唔滿意 o2 唔滿意 o3 無話滿唔滿意 o4 滿意 o5 極滿意 你覺得邊個形 容 詞 最 適 合 形 容 你 的 感 受 ？

1

Occupational Therapy Generic Outcome Study – Psychiatry Day / Out-Patient (25 Apr 02)

PSY-D/O-AD 職業治療服務問卷 (訪問版)

[If interviewer feel that the subject understand well what he/she is requested in answering the question, the next example can be skipped]

我地再試一題 你滿唔滿意職業治療部的環境？ o1 極唔滿意 o2 唔滿意 o3 無話滿唔滿意 o4 滿意 o5 極滿意 你覺得邊個形 容 詞 最 適 合 形 容 你 的 感 受 ？

好 。 呢 份 問 卷 的 題 目 全 部 係 問 你 於 接 受 職 業 治 療 [日 間 醫 院 服 務 前 / 門 診 服 務 前 ]的 感 受，有 部 份 問 題 同 你 的 病 有 直 接 關 係，一 部 份 只 有 間接關係。但每一個問題都係好重要，請你盡量回答所有問題。如 果我們問及一些你沒有接受過的服務，請話比我知。我地而家開始 問。

2

Occupational Therapy Generic Outcome Study – Psychiatry Day / Out-Patient (25 Apr 02)

PSY-D/O-AD 第一節: 接受職業治療[日間醫院服務前/門診服務前]的居住及 工作狀況問卷 請只選一個。 （請在答題簿上適當的格內填上所選之代表數字）

1. 你現在的居住狀況 o01 與親人同住 o04 中途宿舍 o02 獨居 o05 老人宿舍 o03 公司宿舍 o06 殘疾人士宿舍 o11 其他 _____________

o07 公營安老院 o08 私營安老院 o09 醫院

o10 療養院 o12 恩恤徙置(獨居) o13 恩恤徙置(與他人同住)

2. 你滿唔滿意這個居住狀況？ o1 極唔滿意 o2 唔滿意 o3 無話滿唔滿意 o4 滿意 o5 極滿意

3. 你現在的工作狀況

(只選一項)

(工作指賺錢的工作或生意、義工、讀書、照顧家庭包括料理家務、在家照顧小孩或老人等)

o01 全職受薪 o02 固定兼職 o03 全職自僱 o04 兼職自僱 o05 散工

o06 學生 o07 照顧家庭 o08 協助照顧家庭 o09 因殘疾退休 o10 因年老退休

o11 放病假 o12 就讀職業培訓課程 o13 失業 – 正找尋工作 o14 失業 – 沒有找尋工作 o15 其他 _____________

o16 庇護工場 o17 日間醫院 o18 訓練及活動中心學員 o19 訓練及活動中心會員

3a. 如接受職業治療[日間醫院服務前/門診服務前]是在受薪的工作狀況, 請回答 此題: (999 =不適用) 上月的薪金有多少? 3b. 如接受職業治療[日間醫院服務前/門診服務前]是在失業的工作狀況, 請回答 此題: 已失業多少個月? (999 =不適用) 4. 你滿唔滿意你於第三題所描述的工作狀況？ o1 極唔滿意 o2 唔滿意 o3 無話滿唔滿意 o4 滿意 o5 極滿意

5. 你滿唔滿意你的收入？(非就業人士請選不適用) o1 極唔滿意 o2 唔滿意 o3 無話滿唔滿意 o4 滿意 o5 極滿意 o9 不適用 ===========================================================================

5a. 你的主要經濟來源: o1 綜援/傷殘津貼 o3 由家人/朋友支持 o4 自己賺錢

3

Occupational Therapy Generic Outcome Study – Psychiatry Day / Out-Patient (25 Apr 02)

PSY-D/O-AD 第三節: 接受職業治療[日間醫院服務前/門診服務前]的個人表現滿意度 下列問題是關於你在今次接受職業治療[日間醫院服務前/門診服務前]對自己各方面表現的滿意程 度 （請在答題簿上適當的格內填上所選之代表數字） 極

無話滿

唔滿意 唔滿意 唔滿意

極 滿意

滿意

14. 你對自己自我照顧的表現滿唔滿意？

o1

o2

o3

o4

o5

15. 你對自己做家務的表現滿唔滿意？

o

o

o

o

o

16. 你對自己工作的表現滿唔滿意？

o

o

o

o

o

17. 你對自己與人相處或溝通的表現滿唔滿 意？

o

o

o

o

o

18. 你對自己參與康樂或消遣活動的表現滿 唔滿意？

o

o

o

o

o

19. 你對自己應用公共設施的表現滿唔滿 意？(公共設施包括搭車、買? 、去郵局或銀行等。)

o

o

o

o

o

20. 你對自己均衡分配日常活動時間的表現 滿唔滿意？(日常活動是指工作、休息、娛樂社交等活

o

o

o

o

o

(工作指賺錢的工作或生意、義工、讀書、照顧家庭包 括料理家務、在家照顧小孩或老人等)

動。)

4

Occupational Therapy Generic Outcome Study – Psychiatry Day / Out-Patient (25 Apr 02)

PSY-D/O-AD 第四節: 接受職業治療[日間醫院服務前/門診服務前]之整體生活滿意度 下列問題是關於你在今次接受職業治療[日間醫院服務前/門診服務前]對整體生活的滿意程度 （請在答題簿上適當的格內填上所選之代表數字） 極 無話滿 唔滿意 唔滿意 唔滿意

滿意

極 滿意

21. 你滿唔滿意自己的身體狀況？

o1

o2

o3

o4

o5

22. 你滿唔滿意自己和親人的關係？

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

唔

小小

快樂

快樂

快樂

度快樂

快樂

o1

o2

o3

o4

o5

23. 你滿唔滿意自己對家庭或社會的貢獻？ (貢獻是指你對家庭或社會所付出的力量及幫助)

24. 你滿唔滿意自己的精神生活？ (精神生活是指文化、藝術、思想、道德或宗教生活)

25. 你滿唔滿意你的健康狀況？ 26. 你滿唔滿意你的主觀生活質量？【主觀生活質 量是指你對生活各方面的整體感受，包括身體狀況、心情、 能力、家庭、朋友及居住環境等】

27. 整體來講，你覺得你的生活快唔快樂？

5

某程度 好大程

極

Occupational Therapy Generic Outcome Study – Psychiatry Day / Out-Patient (25 Apr 02)

PSY-D/O-DC 醫院管理局 職業治療服務問卷 (訪問版) To be administered by case therapist or interviewer around the time of Discharge (All scores should be entered into the subjects corresponding answer book.) [Interviewer should read the followings to the subject]

我們為你所提供的治療、訓練及服務己暫告一段落, 我們希望透過這份問卷，了 解一下你對我們的服務是否滿意及你對現在生活的滿意程度。你的意見能幫助 我們檢討及改善現在的服務水平。 呢份問卷以訪問形式進行, 我會將問題讀出，你如果唔明白條問題可以問我，跟 著我會讀五個形容詞比你聽，呢五個形容詞係由「最唔滿意」到「最滿意」排 列出來，你只要在五個形容詞當中揀出一個最可以反映你感受的形容詞話比我 知就得。

[Read the followings to the subject for practice.]

例題 我地先試下一些例題 你滿唔滿意現在的生活？ 我先解釋一下。「滿唔滿意」係屬於個人的感受，唔同人對「滿意」的定義 可能唔同， 你只需要就你對「滿意」的理解講出自己的感受。 唔同人評定 「滿意」的標準都可能唔一樣，請你根據你個人的標準同期望來評定你的滿 意程度。 我再讀一次條問題。 你滿唔滿意現在的生活？(停頓兩秒) 我而家讀五個形容詞比你聽。 o1 極唔滿意 o2 唔滿意 o3 無話滿唔滿意 o4 滿意 o5 極滿意 你覺得邊個形容詞最適合形容你的感受？ 我地再試一題 你滿唔滿意有關治療你疾病的設備？(停頓兩秒) o1 極唔滿意 o2 唔滿意 o3 無話滿唔滿意 o4 滿意 o5 極滿意 你覺得邊個形 容 詞 最 適 合 形 容 你 的 感 受 ？

6

Occupational Therapy Generic Outcome Study – Psychiatry Day / Out-Patient (25 Apr 02)

PSY-D/O-DC 職業治療服務問卷 (訪問版)

[If interviewer feel that the subject understand well what he/she is requested in answering the question, the next example can be skipped]

我地再試一題 你滿唔滿意職業治療部的環境？ o1 極唔滿意 o2 唔滿意 o3 無話滿唔滿意 o4 滿意 o5 極滿意 你覺得邊個形 容 詞 最 適 合 形 容 你 的 感 受 ？

好。呢份問卷的題目全部係問你最近兩星期的感受，有部份問題 同你的病有直接關係，一部份只有間接關係。但每一個問題都係 好重要，請你盡量回答所有問題。如果我們問及一些你沒有接受 過的服務，請話比我知。我地而家開始問。

7

Occupational Therapy Generic Outcome Study – Psychiatry Day / Out-Patient (25 Apr 02)

PSY-D/O-DC 第二節: 服務滿意度（需由非治療人員詢問） 下列問題是關於你對職業治療師所提供的治療、訓練及服務的滿意程度。如職業治療師並沒有向你 提供該項服務，請你於該項中揀選「無接受這服務」一欄。 （請在答題簿上適當的格內填上所選之代表數字） 無接受 極 唔滿意 無話滿 這服務 唔滿意 唔滿意

6. 你滿唔滿意有關促進你身體復原的 治療？

滿意

極 滿意

o9

o1

o2

o3

o4

o5

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

10. 你滿唔滿意有關幫助你與人相處或 溝通的訓練及服務？

o

o

o

o

o

o

11. 你滿唔滿意有關幫助你參與康樂或 消遣活動的訓練及服務？

o

o

o

o

o

o

12. 你滿唔滿意有關幫助你使用公共交 通工具或其他公共設施的訓練及服 務？

o

o

o

o

o

o

o

o

o

o

o

o

7. 你滿唔滿意有關幫助你自我照顧的 訓練？ (自我照顧包括：著衫、食飯、梳洗、大小便等等活 動)

8. 你滿唔滿意有關幫助你做家務的訓 練及服務？ 9. 你滿唔滿意有關幫助你回到工作崗 位的訓練及服務？ (工作崗位包括職業崗位、照顧家庭崗位、學生崗位 等等)

13. 你滿唔滿意有關幫助你均衡分配日 常活動時間的訓練及服務？ (日常活動 是指工作、休息、娛樂社交等活動。這條問題的重 點在於就自己身體狀況安排各種活動)

8

Occupational Therapy Generic Outcome Study – Psychiatry Day / Out-Patient (25 Apr 02)

PSY-D/O-DC 第三節: 個人表現滿意度 下列問題是關於你對自己各方面表現的滿意程度 （請在答題簿上適當的格內填上所選之代表數字） 極

無話滿

唔滿意 唔滿意 唔滿意

極 滿意

滿意

14. 你對自己自我照顧的表現滿唔滿意？

o1

o2

o3

o4

o5

15. 你對自己做家務的表現滿唔滿意？

o

o

o

o

o

16. 你對自己工作的表現滿唔滿意？

o

o

o

o

o

17. 你對自己與人相處或溝通的表現滿唔滿 意？

o

o

o

o

o

18. 你對自己參與康樂或消遣活動的表現滿 唔滿意？

o

o

o

o

o

19. 你對自己應用公共設施的表現滿唔滿 意？(公共設施包括搭車、買? 、去郵局或銀行等。)

o

o

o

o

o

20. 你對自己均衡分配日常活動時間的表現 滿唔滿意？(日常活動是指工作、休息、娛樂社交等活

o

o

o

o

o

(工作指賺錢的工作或生意、義工、讀書、照顧家庭包 括料理家務、在家照顧小孩或老人等)

動。)

9

Occupational Therapy Generic Outcome Study – Psychiatry Day / Out-Patient (25 Apr 02)

PSY-D/O-DC 第四節: 整體生活滿意度 下列問題是關於你對整體生活的滿意程度 （請在答題簿上適當的格內填上所選之代表數字） 極

無話滿

唔滿意 唔滿意 唔滿意

極 滿意

滿意

21. 你滿唔滿意自己的身體狀況？

o1

o2

o3

o4

o5

22. 你滿唔滿意自己和親人的關係？

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

唔 快樂

小小 快樂

o1

o2

23. 你滿唔滿意自己對家庭或社會的貢獻？ (貢獻是指你對家庭或社會所付出的力量及幫助)

24. 你滿唔滿意自己的精神生活？ (精神生活是指文化、藝術、思想、道德或宗教生活)

25. 你滿唔滿意你的健康狀況？ 26. 你滿唔滿意你的主觀生活質量？【主觀生活質 量是指你對生活各方面的整體感受，包括身體狀況、心情、 能力、家庭、朋友及居住環境等】

27. 整體來講，你覺得你的生活快唔快樂？

10

某程度 好大程 快樂 度快樂 o3

o4

極 快樂 o5

Occupational Therapy Generic Outcome Study – Psychiatry Day / Out-Patient (25 Apr 02)

PSY-D/O-DC 第五節: 居住及工作狀況問卷 [Out-patient Only] 請只選一格。(請在答題簿上適當的格內填上所選之代表數字)

28. 現在居住狀況 o01 與親人同住 o04 中途宿舍 o02 獨居 o05 老人宿舍 o03 公司宿舍 o06 殘疾人士宿舍 o11 其他 _____________

o07 公營安老院 o08 私營安老院 o09 醫院

o10 療養院 o12 恩恤徙置(獨居) o13 恩恤徙置(與他人同住)

29. 你滿唔滿意你這個居住狀況？ o1 極唔滿意 o2 唔滿意 o3 無話滿唔滿意 o4 滿意 o5 極滿意

30. 現在工作狀況 (工作指賺錢的工作或生意、義工、讀書、照顧家庭包括料理家務、在家照顧小孩或老人等)

o01 全職受薪 o02 固定兼職 o03 全職自僱 o04 兼職自僱 o05 散工

o06 學生 o07 照顧家庭 o08 協助照顧家庭 o09 因殘疾退休 o10 因年老退休

o11 放病假 o12 就讀職業培訓課程 o13 失業 – 正找尋工作 o14 失業 – 沒有找尋工作 o15 其他 _____________

o16 庇護工場 o17 日間醫院 o18 訓練及活動中心學員 o19 訓練及活動中心會員

30a.如現在是在受薪的工作狀況, 請回答此題: (999 =不適用) 最近的一個月薪金有多少? 30b.如現在是在失業的工作狀況, 請回答此題: (999 =不適用) 已失業多少個月? 31. 你滿唔滿意你於第三十題所描述的工作狀況？ o1 極唔滿意 o2 唔滿意 o3 無話滿唔滿意 o4 滿意 o5 極滿意

32. 現在職位狀況 (非就業人士請選不適用) o1 同一公司、同一職位 o2 同一公司、不同職位

o4 同一行業、同一職位 o5 同一行業、不同職位

「行業」指公司的主要業務，「職位」指病人工作的工作性質

o7 不同行業、同一職位 o8 不同行業、不同職位 o9 不適用

33. 現在收入狀況(非就業人士請選不適用) o1 與發病前大致相同

o2 比發病前高

o3 比發病前低

o9 不適用

34. 你滿唔滿意你的收入？(非就業人士請選不適用) o1 極唔滿意 o2 唔滿意 o3 無話滿唔滿意 o4 滿意 o5 極滿意

o9 不適用

======================================================== 34a. 你的主要經濟來源: o1 綜援/傷殘津貼 o3 由家人/朋友支持 o4 自己賺錢

11

Occupational Therapy Generic Outcome Study – Psychiatry Day / Out-Patient (25 Apr 02)

PSY-D/O-DC 第六節: 整體主觀生活質量的改變 (請在答題簿上適當的格內填上所選之代表數字)

35.自從接受職業治療之後，你的整體主觀生活質量有沒有改 善 或 惡 化 ？ o1

極為改善

有很大的改善。 在多個範疇都有改善。

o2

很大改善

有可觀的、明顯的改善。 在一或兩個範疇有很大的改善或在多個範疇有中度的改善。

o3

少許改善

可察覺到少許改善。 有很少但明確改變。可能只影響一個範疇。

o4

不變

沒有可察覺到的改變。

o5

少許惡化

可察覺到少許惡化。 有很少但明顯的改變。可能只影響一個範疇。

o6

很大惡化

有可觀的、明顯的惡化。 在一或兩個範疇中有很大的惡化或 在多個範疇有中度的惡化。

o7

極為惡化

相 對 上 一 次 評 估 /訪 問 有 極 大 的 惡 化 。 在多個範疇上有很大的惡化。

12

Occupational Therapy Generic Outcome Study – Psychiatry Day / Out-Patient (25 Apr 02)

PSY-D/O-DC 整體功能的改變(由治療師作答) (請在答題簿上適當的格內填上所選之代表數字)

36.自從接受職業治療之後，病人的整體功能有沒有改 善 或 惡 化 ？ o1

極為改善

有很大的改善。 在多個範疇都有改善。

o2

很大改善

有可觀的、明顯的改善。 在一或兩個範疇有很大的改善或在多個範疇有中度的改善。

o3

少許改善

可察覺到少許改善。 有很少但明確改變。可能只影響一個範疇。

o4

不變

沒有可察覺到的改變。

o5

少許惡化

可察覺到少許惡化。 有很少但明顯的改變。可能只影響一個範疇。

o6

很大惡化

有可觀的、明顯的惡化。 在一或兩個範疇中有很大的惡化或 在多個範疇有中度的惡化。

o7

極為惡化

相 對 上 一 次 評 估 /訪 問 有 極 大 的 惡 化 。 在多個範疇上有很大的惡化。

13

Occupational Therapy Generic Outcome Study – Psychiatry Day / Out-Patient (25 Apr 02)

PSY-D/O-FU

醫院管理局 職業治療服務問卷 (訪問版) To be administered by case therapist or interviewer around the period of [no. of months]-month follow-up. (All scores should be entered into the subjects corresponding answer book) [Interviewer should read the followings to the subject]

我們為你提供治療、訓練及服務後已大約有【月數】個月, 我們希望透過這份問 卷，了解一下你現在生活各方面的表現及滿意程度。你的意見能幫助我們檢討及 改善將來的服務水平。 呢份問卷以訪問形式進行, 我會將問題讀出，你如果唔明白條問題可以問我，跟 著我會讀五個形容詞比你聽，呢五個形容詞係由「最唔滿意」到「最滿意」排列 出來，你只要在五個形容詞當中揀出一個最可以反映你感受的形容詞話比我知就 得。 [Read the followings to the subject for practice.]

例題 我地先試下一些例題 你滿唔滿意現在的生活？ 我先解釋一下。「滿唔滿意」係屬於個人的感受，唔同人對「滿意」的定義 可能唔同， 你只需要就你對「滿意」的理解講出自己的感受。 唔同人評定 「滿意」的標準都可能唔一樣，請你根據你個人的標準同期望來評定你的滿 意程度。 我再讀一次條問題。 你滿唔滿意現在的生活？(停頓兩秒) 我而家讀五個形容詞比你聽。 o1 極唔滿意 o2 唔滿意 o3 無話滿唔滿意 o4 滿意 o55 極滿意 你覺得邊個形容詞最適合形容你的感受？ 我地再試一題 你滿唔滿意有關治療你疾病的設備？(停頓兩秒) o1 極唔滿意 o2 唔滿意 o3 無話滿唔滿意 o4 滿意 o5 極滿意 你覺得邊個形 容 詞 最 適 合 形 容 你 的 感 受 ？

14

Occupational Therapy Generic Outcome Study – Psychiatry Day / Out-Patient (25 Apr 02)

PSY-D/O-FU 職業治療服務問卷 (訪問版)

[If interviewer feel that the subject understand well what he/she is requested in answering the question, the next example can be skipped]

我地再試一題 你滿唔滿意職業治療部的環境？ o1 極唔滿意 o2 唔滿意 o3 無話滿唔滿意 o4 滿意 o5 極滿意 你覺得邊個形 容 詞 最 適 合 形 容 你 的 感 受 ？

好。呢份問卷的題目全部係問你最近兩星期的感受，有部份問題同 你的病有直接關係，一部份只有間接關係。但每一個問題都係好重 要，請你盡量回答所有問題。如果我們問及一些你沒有接受過的服 務，請話比我知。我地而家開始問。

15

Occupational Therapy Generic Outcome Study – Psychiatry Day / Out-Patient (25 Apr 02)

PSY-D/O-FU 第三節: 個人表現滿意度 下列問題是關於你對自己各方面表現的滿意程度 （請在答題簿上適當的格內填上所選之代表數字） 極

無話滿

唔滿意 唔滿意 唔滿意

極 滿意

滿意

14. 你對自己自我照顧的表現滿唔滿意？

o1

o2

o3

o4

o5

15. 你對自己做家務的表現滿唔滿意？

o

o

o

o

o

16. 你對自己工作的表現滿唔滿意？

o

o

o

o

o

17. 你對自己與人相處或溝通的表現滿唔滿 意？

o

o

o

o

o

18. 你對自己參與康樂或消遣活動的表現滿 唔滿意？

o

o

o

o

o

19. 你對自己應用公共設施的表現滿唔滿 意？(公共設施包括搭車、買? 、去郵局或銀行等。)

o

o

o

o

o

20. 你對自己均衡分配日常活動時間的表現 滿唔滿意？(日常活動是指工作、休息、娛樂社交等活

o

o

o

o

o

(工作指賺錢的工作或生意、義工、讀書、照顧家庭包 括料理家務、在家照顧小孩或老人等)

動。)

16

Occupational Therapy Generic Outcome Study – Psychiatry Day / Out-Patient (25 Apr 02)

PSY-D/O-FU 第四節: 整體生活滿意度 下列問題是關於你對整體生活的滿意程度 （請在答題簿上適當的格內填上所選之代表數字） 極

無話滿

唔滿意 唔滿意 唔滿意

極 滿意

滿意

21. 你滿唔滿意自己的身體狀況？

o1

o2

o3

o4

o5

22. 你滿唔滿意自己和親人的關係？

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

唔 快樂

小小 快樂

o1

o2

23. 你滿唔滿意自己對家庭或社會的貢獻？ (貢獻是指你對家庭或社會所付出的力量及幫助)

24. 你滿唔滿意自己的精神生活？ (精神生活是指文化、藝術、思想、道德或宗教生活)

25. 你滿唔滿意你的健康狀況？ 26. 你滿唔滿意你的主觀生活質量？【主觀生活質 量是指你對生活各方面的整體感受，包括身體狀況、心情、 能力、家庭、朋友及居住環境等】

27. 整體來講，你覺得你的生活快唔快樂？

17

某程度 好大程 快樂 度快樂 o3

o4

極 快樂 o5

Occupational Therapy Generic Outcome Study – Psychiatry Day / Out-Patient (25 Apr 02)

PSY-D/O-FU 第五節: 居住及工作狀況問卷 請只選一格。(請在答題簿上適當的格內填上所選之代表數字)

28. 現在居住狀況 o01 與親人同住 o04 中途宿舍 o02 獨居 o05 老人宿舍 o03 公司宿舍 o06 殘疾人士宿舍 o11 其他 _____________

o07 公營安老院 o08 私營安老院 o09 醫院

o10 療養院 o12 恩恤徙置(獨居) o13 恩恤徙置(與他人同住)

29. 你滿唔滿意你這個居住狀況？ o1 極唔滿意 o2 唔滿意 o3 無話滿唔滿意 o4 滿意 o5 極滿意

30. 現在工作狀況 (工作指賺錢的工作或生意、義工、讀書、照顧家庭包括料理家務、在家照顧小孩或老人等)

o01 全職受薪 o02 固定兼職 o03 全職自僱 o04 兼職自僱 o05 散工

o06 學生 o07 照顧家庭 o08 協助照顧家庭 o09 因殘疾退休 o10 因年老退休

o11 放病假 o12 就讀職業培訓課程 o13 失業 – 正找尋工作 o14 失業 – 沒有找尋工作 o15 其他 _____________

o16 庇護工場 o17 日間醫院 o18 訓練及活動中心學員 o19 訓練及活動中心會員

30a.如現在是在受薪的工作狀況, 請回答此題: (999 =不適用) 最近的一個月薪金有多少? 30b.如現在是在失業的工作狀況, 請回答此題: (999 =不適用) 已失業多少個月? 31. 你滿唔滿意你於第三十題所描述的工作狀況？ o1 極唔滿意 o2 唔滿意 o3 無話滿唔滿意 o4 滿意 o5 極滿意

32. 現在職位狀況 (非就業人士請選不適用) o1 同一公司、同一職位

o4 同一行業、同一職位

o7 不同行業、同一職位

o2 同一公司、不同職位

o5 同一行業、不同職位

o8 不同行業、不同職位 o9 不適用

「行業」指公司的主要業務，「職位」指病人工作的工作性質

33. 現在收入狀況(非就業人士請選不適用) o1 與接受職業治療前大致相同 o3 比接受職業治療前低

o2 比接受職業治療前高 o9 不適用

34. 你滿唔滿意你的收入？(非就業人士請選不適用) o1 極唔滿意 o2 唔滿意 o3 無話滿唔滿意 o4 滿意 o5 極滿意 o9 不適用 ===========================================================================

34a. 你的主要經濟來源: o1 綜援/傷殘津貼 o3 由家人/朋友支持 o4 自己賺錢

18

Occupational Therapy Generic Outcome Study – Psychiatry Day / Out-Patient (25 Apr 02)

PSY-D/O-FU 第六節: 整體主觀生活質量的改變 (請在答題簿上適當的格內填上所選之代表數字)

35.自從 3 個月前的訪問後，你的整體主觀生活質量有沒有改 善 或 惡 化 ？ o1

極為改善

有很大的改善。 在多個範疇都有改善。

o2

很大改善

有可觀的、明顯的改善。 在一或兩個範疇有很大的改善或在多個範疇有中度的改善。

o3

少許改善

可察覺到少許改善。 有很少但明確改變。可能只影響一個範疇。

o4

不變

沒有可察覺到的改變。

o5

少許惡化

可察覺到少許惡化。 有很少但明顯的改變。可能只影響一個範疇。

o6

很大惡化

有可觀的、明顯的惡化。 在一或兩個範疇中有很大的惡化或 在多個範疇有中度的惡化。

o7

極為惡化

相 對 上 一 次 評 估 /訪 問 有 極 大 的 惡 化 。 在多個範疇上有很大的惡化。

19

Occupational Therapy Generic Outcome Study – Psychiatry Day / Out-Patient (25 Apr 02)

PSY-D/O-FU 整體功能的改變(由治療師作答) (請在答題簿上適當的格內填上所選之代表數字)

36.自從 3 個月前的訪問後，病人的整體功能有沒有改 善 或 惡 化 ？ o1

極為改善

有很大的改善。 在多個範疇都有改善。

o2

很大改善

有可觀的、明顯的改善。 在一或兩個範疇有很大的改善或在多個範疇有中度的改善。

o3

少許改善

可察覺到少許改善。 有很少但明確改變。可能只影響一個範疇。

o4

不變

沒有可察覺到的改變。

o5

少許惡化

可察覺到少許惡化。 有很少但明顯的改變。可能只影響一個範疇。

o6

很大惡化

有可觀的、明顯的惡化。 在一或兩個範疇中有很大的惡化或 在多個範疇有中度的惡化。

o7

極為惡化

相 對 上 一 次 評 估 /訪 問 有 極 大 的 惡 化 。 在多個範疇上有很大的惡化。

20

Occupational Therapy Generic Outcome Study – Psychiatry Day / Out-Patient (25 Apr 02)